Objective: Pulmonary embolism (PE) is the third leading cause of cardiovascular death. The objective of this study was to examine the current management of pulmonary embolism at a single academic institution. Methods: With institutional review board approval, we conducted a retrospective chart review of 805 encounters among 775 patients presenting…
Introduction: Although intravenous tissue plasminogen activator (IV tPA) is associated with neurologic deterioration (ND) caused by hemorrhage, whether it attenuates deterioration as a result of other etiologies including progressive stroke remains unexplored. The objective of this study was to determine whether IV tPA is associated with a reduced risk of…
Objectives: The drip and ship model is a method used to deliver thrombolysis to acute stroke patients in facilities lacking onsite neurology coverage. We sought to determine whether our drip and ship population differs from patients treated directly at our stroke center (direct presenters). Methods: We retrospectively reviewed consecutive patients…
Intravenous tissue plasminogen activator (IV tPA, alteplase) provides a statistically and clinically significant improvement in clinical outcome for carefully selected patients with acute ischemic stroke when administered within 4.5 hours of onset; however, even within the 4.5-hour window, outcome is poor for some eligible patients, including those with occlusions of…
Pulmonary embolism is a common and sometimes devastating disease caused by many factors, most commonly deep venous thrombosis. Treatment is typically systemic anticoagulation depending on patient clinical presentation. For patients with life threatening pulmonary embolism, IV tPA (Activase, Genentech, South San Francisco, CA) is the most common medication given emergently…
Cholesterol embolization syndrome is a rare but devastating complication of thrombolysis. Clinical presentations are variable, which has resulted in labeling this syndrome as the great masquerader. Almost every organ in the body may be affected, but the syndrome commonly involves the kidney, skin, central nervous system, and gastrointestinal tract. Treatment…
Even with the benefit of cardiopulmonary resuscitation, the prognosis of cardiac arrest remains poor. Multiple case series describe survival with the use of thrombolytic therapy for refractory cardiac arrest. Presumably thrombolysis treats that subset of cardiac arrest cases resulting from fulminant pulmonary embolism, or perhaps massive myocardial infarctions. Published reports…
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